Exam 4 Flashcards
Thyroid & Antithyroid, Diabetes, Bowel & Antiemetics, Vitamins
Early Symptoms of Hypothyroidism
General weakness, muscle cramps, dry skin
Late Symptoms of Hypothyroidism
Slurred speech, bradycardia, weight gain, cold intolerance
Adverse Effects of Thyroid Replacement Drugs:
-CV: tachycardia, palpitations, angina, HTN, cardiac dysrhythmias
-CNS: (excitation!) insomnia, tremors, HA, anxiety
-GI: nausea, diarrhea, cramps
-Other: weight loss, heat intolerance, menstrual irregularities, sweating, fever
Administration Alerts for Thyroid Replacement Drugs:
-administer in the morning at least 30 mins before eating or drinking
-take at the same time every day
-don’t take calcium or iron supplements within 4 hours of levothyroxine
Levothyroxine
Thyroid Replacement Drug
-drug of choice
Liothyronine
Thyroid Replacement Drug
Liotrix
Thyroid Replacement Drug
What is the most common cause of hyperthyroidism?
Grave’s Disease
Symptoms of Hyperthyroidism
Increased metabolism, tachycardia, weight loss, anxiety
Thyroid Storm
life-threatening form of hyperthyroidism; if left untreated, mortality rates are 80-90%
Adverse Effects of Antithyroid Drugs:
Liver & bone marrow toxicity, thrombocytopenia, aplastic anemia
Administration Alerts for Antithyroid Drugs:
-Notify MD immediately if pregnancy is suspected
Methimazole
Antithyroid
-drug of choice
Propylthiouracil
Antithyroid
Signs & Symptoms of Diabetes:
-fasting BG >126
-Polyuria, polyphagia, polydispsia
-glucosuria
-fatigue
Acute Diabetic Complications:
-DKA (excessively high BG)
-Ketones in blood & urine
-Acidosis
-Dehydration
-Electrolyte imbalances
Long-term Diabetic Complications:
Macrovascular (atherosclerotic plaque formation) & Microvascular (retinopathy, neuropathy, nephropathy)
Type 1 DM
-Caused by an absolute lack of insulin production or the production of defective insulin
-Autoimmune
-10% of DM cases
-Tx: dietary restrictions, exercise, INSULIN THERAPY
Adverse Effects of Insulin Therapy:
-Hypoglycemia (caused by insulin OD, improper timing, skipping a meal)
-Hyperglycemia (caused by underdose of insulin, stress, trauma on body)
Symptoms of Hypoglycemia
tachycardia, confusion, sweating, drowsiness, coma & eventually death
Symptoms of Hyperglycemia
polyuria, polyphagia, polydipsia, glucosuria, fatigue
Onset of Rapid Insulin
30 mins
Duration of Rapid Insulin
3-5 hours
Insulin Aspart (Fiasp, NovoLog)
-Rapid
-Peak: 1-3 hours
-Admin: subq, 30 mins before meal
Insulin Lispro (Ademalog, Humalog)
-Rapid
-Peak: 30-60 mins
-Admin: subq, 30 mins before meal
Insulin Glulisine (Apidra)
-Rapid
-Peak: 60-90 mins
-Admin: subq, 30 mins before meals
Regular Insulin (Humulin R, Novolin R)
-Short
-Onset: 30-60 mins
-Peak: 2-4 hours
-Duration: 5-8 hours
-Admin: subq or IV, 30-60 mins before meals
Insulin Isophane (NPH, Humulin N, Novolin N)
-Intermediate
-Onset: 1-2 hours
-Peak: 4-12 hours
-Duration: 18-24 hours
-Admin: subq, 30 mins before first meal of day and again 30 mins before supper if needed
-DO NOT mix with glargine
Insulin Degludec
-Long
-Onset: 1.6 hours
-No peak
-Duration: to 42 hours
-DO NOT MIX
Insulin Detemir
-Long
-Onset: 1.6 hours
-No peak
-Duration: to 24 hours
-DO NOT MIX
Insulin Glargine
-Long
-Onset: 1.5 (Lantus), 6 hours (Toujeo)
-No peak (Lantus), 12 hours (Toujeo)
-Duration: to 24 hours
-DO NOT MIX
Type 2 DM:
-Insulin resistance
-90% DM cases
-Tx: healthy diet, exercise
Metformin (B)
-Diabetes drug
-Drug of choice for type 2 DM
-Does NOT cause hypoglycemia
Adverse Effects of Metformin
GI upset, HA, dizziness, agitation, fatigue
Glimepiride
Diabetes Drug
Glyburide
Diabetes Drug
Adverse Effects of Diabetes Drugs:
Hypoglycemia, hematologic effects, nausea, epigastric fullness, heartburn
Laxatives & Cathartics
Treat or prevent constipation, prepare bowel for surgery or diagnostic procedures
Psyllium
-Bulk-forming laxative
Methylcellulose
-Bulk-forming Laxative
Bulk-forming laxative adverse effects:
Abdominal fullness or cramping, fainting, esophageal or GI obstruction if taken with insufficient fluid (8 oz!)
Docusate Sodium & Adverse Effects:
-Stool softener
-abdominal cramping, diarrhea
Bisacodyl & Adverse Effects:
-Stimulant
-abdominal cramping, nausea, fainting, diarrhea, fluid & electrolyte loss
Magnesium Hydroxide Adverse Effects:
abdominal cramping, diarrhea, hypermagnesemia, dysrhythmias, respiratory failure
(drink 8-10 glasses/day of water)
Antidiarrheals
Used to treat diarrhea
Lomotil
antidiarrheal
Imodium
Antidiarrheal
Paregoric
Antidiarrheal
Adverse Effects of Antidiarrheals:
drowsiness, lightheadedness, nausea, dry mouth, constipation, respiratory depression, CNS depression
Irritable Bowel Syndrome (IBS)
-Disorder of lower GI tract
-Symptoms: abdominal pain, cramping, bloating, gas, constipation alternating with diarrhea
Alosteron & Adverse Effects:
-Used to treat IBS with diarrhea
-constipation, abdominal discomfort, nausea, rash, ischemic colitis
Lubiprostone & Adverse Effects:
-Used to treat IBS with constipation
-nausea, diarrhea, HA, dyspnea, allergic reaction
Inflammatory Bowel Disease (IBD)
-Includes UC & CD
-Symptoms: abdominal cramping, diarrhea w/periods of exacerbation and remission
Mesalamine
Treats IBD
Sulfasalazine
Treats IBD
Adverse Effects for IBD Drugs:
HA, abdominal pain, diarrhea, N/V, rash, flulike illness, hepatotoxicity, CKD
Scopolamine & Adverse Effects:
-Antiemetic, transdermal patch for preventing motion sickness
-Drowsiness, dry mouth, blurred vision
Metoclopramide (reglan) & Adverse Effects:
-Antiemetic
-dry eyes, blurred vision, dry mouth, constipation, drowsiness, photosensitivity
Ondansetron (Zofram) & Adverse Effects:
-Antiemetic
-HA, drowsiness, fatigue, constipation, diarrhea
Vitamin A (Retinol)
Helps maintain normal vision & night vision
Common Causes of VITAMIN A Deficiency:
Prolonged dietary deprivation, pancreatic diseases, cirrhosis
Dietary Sources of VITAMIN A:
yellow & dark green leafy vegetables, butter, eggs, whole milk, liver
Vitamin D
Responsible for proper utilization of calcium & phosphorous, prevention of osteoporosis
Vitamin D2
Obtained through diet
-fish liver oils, fish
-fortified foods: milk, OJ, cereals
-animal livers, eggs, butter, dairy products
Vitamin D3
Produced in skin through UV
Vitamin B1 (Thiamine)
Helps convert food into energy
Causes of VITAMIN B1 Deficiency:
Alcoholism, chronic liver disease, HIV, DM, older adults
Dietary Sources of VITAMIN B1:
plant & animal products, whole-grains, dried beans, peanuts
Vitamin B12 (Riboflavin)
Needed for normal respiratory function, maintains erythrocyte integrity
Causes of VITAMIN B12 Deficiency:
Intestinal malabsorption, long-term infections, liver disease, malignancy, alcoholism
Dietary Sources of VITAMIN B12:
green & leafy vegetables, eggs, dairy, nuts, legumes, meats, liver, yeast, enriched whole-grains
Vitamin B6 (Pyrixodine)
Necessary for many metabolic functions & integrity of peripheral nerves, skin, mucous membranes
Causes of VITAMIN B6 Deficiency:
inadequate intake, poor absorption, uremia, alcoholism, cirrhosis, hyperthyroidism, heart failure
Dietary Sources of VITAMIN B6:
liver, kidney, fish, shellfish, poultry, milk, eggs, blue cheese, fortified cereals
Vitamin C (Ascorbic Acid)
Required for metabolic activties
Dietary Sources for VITAMIN C:
Citrus fruits, strawberries, tomatoes, potatoes, broccoli, spinach, brussel sprouts, cabbage, green peppers, liver
Scurvy
Prolonged Vitamin C deficiency
Vitamin E
Primary antioxidant
Causes of VITAMIN E Deficiency:
prematurity, malabsorption
Dietary Sources of VITAMIN E:
Plant-seed oils, whole-grain cereals, eggs
Vitamin K
Tx for patients with clotting disorders, wound healing
Dietary Sources of VITAMIN K:
green leafy vegetables, tomatoes, cauliflower, egg yolks, cheese, liver